The surgery of intra-orbital hydatid cyst: a case report and literature review.

Intra-orbital hydatid cyst is a very rare pathological entity that affects children and the young adults; it is secondary to the development in the orbit of the echinococcus granulosis tapeworm. Its frequency does not exceed 1% of all cases of hydatid disease. Clinical presentation of intra-orbital hydatid cyst is dominated by proptosis and a decrease in visual acuity, complete surgical excision is difficult, evolution is generally better when the treatment is early before the installation of irreversible optic atrophy. We report one case of a 3 years old girl operated for right intra-orbital hydatid cyst who presented with proptosis and blindness. Complete removal was difficult and puncture of the cyst was performed followed by excision of its membrane with good post-operative results. We also discuss the different epidemiological, clinical, radiological and therapeutic aspects of intra-orbital hydatid cyst and a review of literature of this rare pathology.

Hydatidosis of infratemporal fossa with proptosis - an unusual presentation: a case report and review of the literature.

BACKGROUND: Hydatid disease is one of the common zoonotic diseases caused by the larval stage of Echinococcus granulosus. It is endemic in sheep-raising and cattle-raising areas worldwide and humans are an accidental intermediate host following the ingestion of the larvae. Head and neck involvement of echinococcosis is a rare entity and involvement of the infratemporal region is extremely rare even in endemic areas. Only a few cases of hydatid cysts located in the infratemporal fossa have been reported in the literature. Moreover, extension of the hydatid cyst into the intraorbital region and infiltrating into the surrounding orbital bone is even rarer. CASE PRESENTATION: We present a case of a 65-year-old Gurung Nepalese woman with painless proptosis of her left eyeball of 2 months' duration with recent progressive diminution of vision for 15 days. Radiological findings showed a cystic mass in the left infratemporal fossa extending into the left orbit and involving the surrounding orbital bone. Surgical removal was carried out. On histopathological evaluation, it was reported as hydatid cyst infiltrating into the bone. She was prescribed albendazole and discharged after surgery. However, she was lost to follow up and returned after 15 months with recurrence and proptosis of the same eye. Repeat excision of the lesion was carried out and postoperatively she was administered tablet albendazole. She was found to be disease free after 6 months of follow up. CONCLUSIONS: Clinical and radiological findings are important but may not be sufficient in the preoperative diagnosis of hydatid disease especially if rare sites are involved. Proptosis may be seen in several conditions and orbital or infratemporal hydatidosis, although rare, should be considered a differential diagnosis.

Primary Orbital Hydatid Cyst: A Case Report.

Hydatid cyst is a rare parasitic infection that involved all organs. It caused by the larval stage of Echinococcus tapeworms. Hydatid cyst of the head and neck is a very rare condition, even in areas where Echinococcus infestation is endemic. Orbital hydatid cyst is extremely rare and accounts for less than 1% of all hydatid cysts. Herein a 24-year-old man with primary orbital hydatid cyst is introduced. He complained from proptosis and diplopia. MRI images revealed a lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which displaced the optic nerve inferiorly and the globe inferolateral. The cyst was enucleated via frontotemporal craniotomy and superior orbitotomy approach. Histopathological examination of the fluid confirmed the diagnosis of hydatid cyst. Treatment of the orbital hydatid cyst is surgical excision followed by the systemic use of albendazole.

Orbital cysticercosis: masquerading as orbital inflammatory disorder.

An eight-year-old female presented with symptoms and signs of orbital inflammation and proptosis. Enzyme-linked immunosorbent assay and magnetic resonance imaging confirmed the diagnosis of extraocular myocysticercosis. Oral treatment with albendazole and steroids was followed by spontaneous extrusion and resolution of the disease.

Proptosis of eyeball in children with medial rectus cysticercosis: report of 2 cases.

PURPOSE: To report 2 children with medial rectus cysticercosis presenting as proptosis of eyeball. METHODS: Case report. RESULTS: In orbital cysticercosis, extraocular muscle cysticercosis is the most common type. Two children, a 12-year-old girl and an 8 year-old boy, presented with proptosis and pain in the left eye. Both were diagnosed with medial rectus cysticercosis based on computed tomographic scan and serologic report and treated with oral albendazole and prednisolone without any residual ocular motility restriction. CONCLUSIONS: We report 2 cases of medial rectus muscle enlargement caused by cysticercosis; describe its clinical importance, diagnosis, and treatment; and present a review of the literature.

Orbital hydatid cyst: review of 10 cases.

BACKGROUND: Echinococcosis represents one of the most common human parasitoses in some geographical areas. Orbital involvement is extremely rare. MATERIALS AND METHODS: In the records of our Medical University Centre between 1984 and 2006, we found 10 cases of orbital hydatid cyst. RESULTS: Among them, 6 males and 4 females; the ages ranged from 2 to 60 years and 7 cases (70%) were less than 12 years of age. The main symptoms of orbital hydatid cyst were slowly progressive unilateral proptosis (100%) with visual loss (90%). The presumptive diagnosis was made on the images obtained from computed tomography and/or magnetic resonance imaging. Surgical removal was the main treatment; although, it is frequently complicated with cyst rupture and spillage of the contents. For this reason, we adopted the technique of cyst puncture with irrigation. A postoperative antihelminthic treatment has always been used. CONCLUSION: Hydatid cyst is an endemic disease in Morocco. Orbital involvement should be considered in the differential diagnosis of proptosis especially in children known to have been in affected geographical areas.

Extraocular muscle cysticercosis: clinical features and management outcome.

BACKGROUND: Extraocular muscle cysticercosis is rare and can be classified based on the stage of evolution as viable, degenerating, and inactive. A tailored approach to therapy using a combination of albendazole and steroids has been proposed. In this study, we have evaluated the clinical features and response of "viable" extraocular muscle cysticercosis to a tailored therapy with oral albendazole and steroids. METHODS: A retrospective review of 32 patients with viable extraocular muscle cysticercosis was performed over a 3-year period. Ultrasound examination was performed at 3 weeks and 6 weeks for resolution of the cyst and clinical signs following treatment with oral albendazole and prednisolone. The clinical presentation, ocular alignment, motility restriction, and ultrasound examination details were recorded on serial visits. RESULTS: The mean age was 19.5 years. The most common presenting signs included limitation of ocular motility in 75%, conjunctival mass in 37.5%, diplopia in 28.1%, and proptosis in 28.1% of the patients, respectively. Ocular alignment evaluation revealed esotropia in 3.1%, exotropia in 12.5%, and hypertropia in 6.25%. Restriction of abduction and abduction in elevation was present in two patients each. The average time for complete resolution was 65.9 days. All the patients had resolution, except four, who had residual motility limitation but were asymptomatic. CONCLUSIONS: Combination therapy with oral albendazole and steroids is effective in the management of viable extraocular muscle cysticercosis. However, residual motility restriction may persist despite treatment.

[Orbital hydatid cyst]. / Kyste hydatique de l'orbite.

CASE: A 72-year-old man presented with left exophthalmia, impaired visual acuity and ocular pain. CT revealed a posterolateral homogeneous unilocular cyst in the left orbital cavity. Ultrasound showed a 38 x 17 mm purely cystic retro-ocular thin lined mass. Hydatid serologic tests were positive. The cyst was completely enucleated, after irrigation with hypertonic saline solution. The diagnosis was confirmed histologically. DISCUSSION: The orbital hydatic cyst is a rare pathology in Western countries but remains relatively frequent in North-African countries. It can be observed in urban centers a high percentage of immigrant population. It is thus necessary to keep this pathology in mind when confronted to an intra-orbital cystic formation and to avoid its rupture.

Orbital hydatid cyst in childhood: a report of two cases.

Intraorbital hydatid disease (IHD) is quite rare and represents < 1% of the Echinococcus cases. In our current communication, we report two children with solitary, primary intraorbital hydatid cysts. Both children presented with nontender, nonpulsatile proptosis. Imaging workup, including CT and MRI scans of the head and the orbits, revealed a retro-bulbar cyst in both patients. Surgical resection was performed by employing a fronto-temporo-orbito-zygomatic (FTOZ) approach. Accidental intraoperative rupture occurred in one case with no further consequences. Albendazole was postoperatively employed for 12 weeks. Outcome was excellent in both cases with complete resolution of their symptoms and complete visual recovery. Pertinent literature was reviewed with this opportunity.

CT in the diagnosis of isolated cysticercal infestation of extraocular muscle.

AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation.

[Hydatid orbital cyst: a unique intra-orbital locality. A case report]. / Kyste hydatique de l'orbite: localisation intra-orbitaire unique. A propos d'une observation.

Orbital hydatidosis is uncommon, accounting for 1 to 2% of all localizations. It is caused by Echinococcus granulosis, a dog parasite tapeworm. We report an intra-orbital hydatid cyst observed in a five-year-old boy, presenting the main features of this unusual localization. Hydatid cyst should be evoked in case of tumorous exophthalmia in young patients, especially in children having lived in endemic zones. The preoperative diagnosis is based on clinical findings and ultrasonographic, computed tomographic and magnetic resonance imaging findings. The fronto-orbital approach is most commonly used for treatment. Infectious and functional prognosis depends on early surgery.

Orbital hydatid cysts: sonographic and CT appearance.

Two cases of unilateral proptosis due to orbital hydatid cysts were evaluated by ultrasound and computed tomography. Image morphology of this rare disease is presented.

Hydatid cyst of the orbit with papilloedema.

A rare case of Hydatid cyst of the orbit causing, unilateral axial proptosis is reported. The presence of gross unilateral papilloedema misled us to the character of the cystic swelling causing axial proptosis.